Provider Demographics
NPI:1356647135
Name:NAZARIO, LUIS E
Entity Type:Individual
Prefix:MR
First Name:LUIS
Middle Name:E
Last Name:NAZARIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF VETERANS AFFAIRS GUAYAMA CBOC FISA BLDG.
Mailing Address - Street 2:1ST FLOOR, PASEO DEL PUEBLO KM 0.3 LOT#6
Mailing Address - City:GUAYAMA
Mailing Address - State:PR
Mailing Address - Zip Code:00784
Mailing Address - Country:US
Mailing Address - Phone:787-866-8886
Mailing Address - Fax:787-866-8795
Practice Address - Street 1:DEPARTMENT OF VETERANS AFFAIRS GUAYAMA CBOC FISA BLDG.
Practice Address - Street 2:1ST FLOOR, PASEO DEL PUEBLO KM 0.3 LOT#6
Practice Address - City:GUAYAMA
Practice Address - State:PR
Practice Address - Zip Code:00784
Practice Address - Country:US
Practice Address - Phone:787-866-8886
Practice Address - Fax:787-866-8795
Is Sole Proprietor?:No
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)